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Second, we aimed to identify a correlation between clinical tumor stage (cT) and TRG, and to define the accuracy of magnetic resonance imaging (MRI) in the restaging setting. Between January 2017 and June 2019, a cross sectional\u00a0multicentric\u00a0study was performed in\u00a022\u00a0referral centers of colon-rectal surgery including all patients with cT3-4Nx\/cTxN1-2\u00a0rectal cancer who underwent pre-operative\u00a0CRT.\u00a0Shapiro\u2013Wilk test was used for continuous data. Categorical variables were compared with Chi-squared test or Fisher\u2019s exact test, where appropriate. Accuracy of restaging MRI in the identification of pathologic complete response (pCR) was determined evaluating the correspondence with the histopathological examination of surgical specimens.<\/jats:p><jats:p>In the present study, 689 patients were enrolled. Complete tumor\u00a0regression rate was 16.9%. The \u201cwatch and wait\u201d strategy was applied in 4.3% of TRG4 patients. A clinical correlation between more advanced tumors and moderate to absent tumor regression was\u00a0found (<jats:italic>p<\/jats:italic>\u2009=\u20090.03). Post-neoadjuvant\u00a0MRI had low sensibility (55%) and high specificity (83%) with accuracy of 82.8% in identifying TRG4 and pCR.<\/jats:p><jats:p>Our data provided a contemporary description of the effects of pre-operative CRT on a large pool of locally advanced low rectal cancer patients treated in different colon-rectal surgical centers.<\/jats:p>","DOI":"10.1007\/s13304-021-01044-0","type":"journal-article","created":{"date-parts":[[2021,4,5]],"date-time":"2021-04-05T09:02:57Z","timestamp":1617613377000},"page":"1795-1803","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Contemporary snapshot of tumor regression grade (TRG) distribution in locally advanced rectal cancer: a cross sectional multicentric 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